HEI Frequently Asked Questions

The annual Healthcare Equality Index (HEI) is used by inpatient and outpatient healthcare organizations nationwide to strengthen the care they give LGBT patients and reach out to this long overlooked group.

The HEI is an online survey open for participation annually from February through June. Created in 2007, the HEI has been skillfully designed to meet the needs of all healthcare organizations seeking to provide optimal care to LGBT patients and to meet CMS and Joint Commission requirements related to this increasingly visible group.

In the first section of the HEI, participating organizations are asked to document whether they meet the “Core Four” foundational criteria for LGBT patient-centered care, which incorporate CMS and Joint Commission requirements. In this section, organizations are also given the opportunity to enroll staff members at all levels for free, expert training in LGBT care.

Responses to the Core Four questions are listed by organization in the HEI annual report and determine whether organizations are designated as "Leaders in LGBT Healthcare Equality." Leaders are featured in the HEI annual report and website, and receive a coveted logo and outreach tools that they can use to publicize their commitment to equity and inclusion.

The second section of the HEI, the Additional Best Practices Checklist, is designed to familiarize organizations with a wide range of recommended practices in LGBT patient-centered care, so that they can identify and remedy gaps. Responses to these questions are not shown by organization in the HEI report (they are aggregated) and they don’t affect Leader status. Instead, responses in this section are returned to participating organizations in a unique, customized analysis that can be used for benchmarking, needs assessment, and strategic planning.

LGBT patients face very significant challenges in healthcare: 56% of lesbian, gay, and bisexual people report experiences of serious discrimination in healthcare, while 70% of transgender people report serious discrimination. In response, CMS and The Joint Commission have issued requirements for LGBT equity and inclusion, and expert recommendations have now emerged for LGBT patient-centered care.

The HEI enables healthcare organizations to assess their own policies and practices vis-à-vis these requirements and recommendations, and equips them with the training and resources they need to remedy gaps. It also enables organizations to receive public recognition for their commitment to equity and inclusion.

Hundreds of healthcare organizations nationwide have participated in the HEI to:

Increase patient safety and satisfaction

Comply with CMS and Joint Commission requirements

Minimize risk and maximize quality

Enhance their reputation for equity and inclusion

And HEI participants enjoy these unique benefits:

Access to free, expert online training for staff at all levels

Customized analysis of potential gaps, with resources for addressing them

The HEI, including the extensive training offered to participating organizations, is offered free of charge, as an educational program of the HRC Foundation.

Participation in the HEI requires a login. If your organization does not already have a login, you can register to receive one, which will enable you to view the HEI with no obligation.

The HEI is designed to be highly accessible and easy to use. The first section, the Core Four Leader Criteria, asks participants to show that they meet foundational criteria incorporating CMS and Joint Commission requirements, and also offers the opportunity for free expert training. The second section, the Additional Best Practices Checklist, allows organizations to see a broad range of policies and practices for LGBT patient-centered care, to assess their own policies and practices and to identify any gaps. The Checklist generates a custom analysis your organization can use for benchmarking, needs assessment and strategic planning.

Help text and other resources are plentiful within the HEI, and HEI staff are always available to assist. The HEI can be completed by any number of people within an organization--the HEI login can be shared—but each organization is asked to designate an “official submitter” to review and submit the HEI.

HEI staff review HEI submissions on a rolling basis, contacting participating organizations with any questions before providing all participants with a custom analysis of their responses. This analysis highlights their responses to the Core Four criteria, which determine HEI Leader status, and includes a wealth of information for strategic planning vis-à-vis LGBT care.

The HEI is open to all healthcare organizations in the U.S. with 100 or more employees, whether inpatient or outpatient, network or individual facility. Inpatient facilities are particularly encouraged to participate, and constitute the majority of participants.

All organizations participating in the HEI may register staff for acclaimed, expert online training—in fact, training is required to be awarded HEI Leader status. Complete details are available within the HEI.

Survey participants that meet the Core Four Leader Criteria are designated as a Leader in LGBT Healthcare Equality. The Equality Leader designation signals to LGBT patients and allies that the healthcare facility has meet the foundational elements of LGBT patient-centered care. Prior to the release of the HEI report, Equality Leaders receive the coveted HEI Leader logo for their use, as well as extensive resources for publicizing their achievement and conducting outreach to LGBT community members.

HEI staff will notify all survey participants whether or not they have received Equality Leader status once the review of that facility’s survey is complete.

Yes. The HEI is revised annually to incorporate new issues and resources related to LGBT patient-centered care, and Leader status is determined each year by an organization’s responses to the HEI in that year. But organizations do not need to resubmit their responses and documentation every year, unless they would like to report changes.